CTA Characteristics of the Circle of Willis and Intracranial Aneurysm in a Chinese Crowd with Family History of Stroke.

Zhangning Jin ,Jia Li,Jun Tu,Jing Zhang,Zhen Zhang,Feng Gao,Xiaokui Kang ,Wu Dong ,Yang Shen ,Nai-Xin Li,Jianning Zhang ,Xianjia Ning ,Nannan Gao ,Jinghua Wang ,Jiang Yingjian ,Fengtan Li ,Litong Zhang ,Xinwang Cai ,Haining Wang ,Xinyu Yang

doi:10.1155/2016/1743794

Abstract

Background and Purpose. The vascular morphology in crowd with family history of stroke remains unclear. The present study clarified the characteristics of the intracranial vascular CoW and prevalence of intracranial aneurysms in subjects with family history of stroke. Methods. A stratified cluster, random sampling method was used for subjects with family history of stroke among rural residents in Jixian, Tianjin, China. All the subjects underwent a physical examination, head computed tomography (CT) scan, and cephalic and cervical computed tomography angiography (CTA) scan. Anatomic variations in the Circle of Willis and cerebrovascular disease in this population were analyzed. Results. In the crowd with similar living environment, stable genetic background, and family history of stroke and without obvious nerve function impairment (1) hypoplasia or absence of A1 segment was significantly different in gender (male versus female: 9.8% versus 18.8%, p = 0.031), especially the right-side A1 (male versus female: 5.9% versus 16.4%, p = 0.004). (2) Hypoplasia or absence of bilateral posterior communicating arteries was more common in men than women (58.2% versus 45.3%, p = 0.032). Unilateral fetal posterior cerebral artery was observed more often in women than men (17.2% versus 8.5%, p = 0.028). (3) The percentage of subjects with incomplete CoW did not increase significantly with age. Compared to healthy Chinese people, the crowd had a higher percentage of incomplete CoW (p < 0.001). (4) No obvious correlation between risk factors and CoW was found. (5) The prevalence of aneurysm was 10.3% in the special crowd. Conclusions. The certain variations of CoW showed significant relation to gender, but not to age in people with family history of stroke. The incomplete circle may be a dangerous factor that is independent of common risk factors for stroke and tend to lead to cerebral ischemia in the crowd with family history of stroke. The prevalence of intracranial aneurysm is comparatively high in the present subjects compared to other people.

Highlights

In China, stroke has exceeded heart disease to become the leading cause of death and adult disability, which causes approximately 116 deaths in population of 100 000 in urban areas and 111 deaths in rural areas [1]
Two subjects had a history of spontaneous subarachnoid hemorrhage (SAH): one had undergone anterior communicating artery (AcomA) aneurysm embolization treatment, and the other one was SAH of unknown origin after examination
As for the overall Circle of Willis (CoW) morphology, no obvious change was observed with respect to sex or ages, supporting the knowledge that CoW is primarily genetically determined

Summary

Introduction

In China, stroke has exceeded heart disease to become the leading cause of death and adult disability, which causes approximately 116 deaths in population of 100 000 in urban areas and 111 deaths in rural areas [1]. All the studies in population with family history of stroke did not explore the relevant cerebrovascular morphology, especially the morphology of Circle of Willis (CoW), which is directly related to cerebral blood supply. The present study clarified the characteristics of the intracranial vascular CoW and prevalence of intracranial aneurysms in subjects with family history of stroke. A stratified cluster, random sampling method was used for subjects with family history of stroke among rural residents in Jixian, Tianjin, China. The certain variations of CoW showed significant relation to gender, but not to age in people with family history of stroke. The incomplete circle may be a dangerous factor that is independent of common risk factors for stroke and tend to lead to cerebral ischemia in the crowd with family history of stroke. The prevalence of intracranial aneurysm is comparatively high in the present subjects compared to other people

Methods

Results

Discussion

Conclusion